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Article ; Online: Prevalence and Clinical Characteristics of Patients with Torsades de Pointes Complicating Acquired Atrioventricular Block

Sok-Sithikun Bun / Nathan Heme / Florian Asarisi / Fabien Squara / Didier Scarlatti / Pamela Moceri / Emile Ferrari

Journal of Clinical Medicine, Vol 12, Iss 1067, p

2023 Volume 1067

Abstract: Background: Female gender, degree of QT prolongation, and genetic susceptibility are known risk factors for developing torsades de pointes (TdP) during high-grade atrioventricular block (HG-AVB). Our objective was to analyze the prevalence and clinical ... ...

Abstract	Background: Female gender, degree of QT prolongation, and genetic susceptibility are known risk factors for developing torsades de pointes (TdP) during high-grade atrioventricular block (HG-AVB). Our objective was to analyze the prevalence and clinical characteristics of patients presenting with TdP and AVB (TdP [+]) in comparison with non-TdP patients with AVB (TdP [−]). Methods: All the ECGs from patients prospectively admitted for AVB (2 to 1, HG, and complete) at the University Hospital of Nice were analyzed. Automated corrected QT (QTc), manual measurements of QT and JT intervals, and Tpeak-to-end were performed at the time of the most severe bradycardia. Results: From September 2020 to November 2021, 100 patients were admitted for HG-AVB. Among them, 17 patients with TdP were identified (8 men; 81 ± 10 years). No differences could be identified concerning automated QTc, manual QTc (Bazett correction), baseline QRS width, or mean left ventricular ejection fraction between the two groups. Potassium serum level on admission and mean number of QT-prolonging drugs per patient were not significantly different between the two groups, respectively: 4.34 ± 0.5 mmol/L in TdP [+] versus 4.52 ± 0.6 mmol/L ( p = 0.33); and 0.6 ± 0.7 in TdP [+] versus 0.3 ± 0.5 ( p = 0.15). In contrast, manual QTc FR (Fridericia correction), JT (Fridericia correction), Tpeak-to-end, and Tpe/QT ratio were significantly increased in the TdP [+] group, respectively: 486 ± 70 ms versus 456 ± 53 ms ( p = 0.04); 433 ± 98 ms versus 381 ± 80 ms ( p = 0.02); 153 ± 57 ms versus 110 ± 40 ms ( p < 0.001); and 0.27 ± 0.08 versus 0.22 ± 0.06 ( p < 0.001). Conclusions: The incidence of TdP complicating acquired AVB was 17%. Longer QTc FR , JT, and Tpeak-to-end were significantly increased in the case of TdP but also in the presence of permanent AVB during the hospitalization.
Keywords	atrioventricular block ; torsades de pointes ; QT interval ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Characterizing interactions between cardiac shape and deformation by non-linear manifold learning.

Maxime, Di Folco / Pamela, Moceri / Patrick, Clarysse / Nicolas, Duchateau

Medical image analysis

2021 Volume 75, Page(s) 102278

Abstract: In clinical routine, high-dimensional descriptors of the cardiac function such as shape and deformation are reduced to scalars (e.g. volumes or ejection fraction), which limit the characterization of complex diseases. Besides, these descriptors undergo ... ...

Abstract	In clinical routine, high-dimensional descriptors of the cardiac function such as shape and deformation are reduced to scalars (e.g. volumes or ejection fraction), which limit the characterization of complex diseases. Besides, these descriptors undergo interactions depending on disease, which may bias their computational analysis. In this paper, we aim at characterizing such interactions by unsupervised manifold learning. We propose to use a sparsified version of Multiple Manifold Learning to align the latent spaces encoding each descriptor and weighting the strength of the alignment depending on each pair of samples. While this framework was up to now only applied to link different datasets from the same manifold, we demonstrate its relevance to characterize the interactions between different but partially related descriptors of the cardiac function (shape and deformation). We benchmark our approach against linear and non-linear embedding strategies, among which the fusion of manifolds by Multiple Kernel Learning, the independent embedding of each descriptor by Diffusion Maps, and a strict alignment based on pairwise correspondences. We first evaluated the methods on a synthetic dataset from a 0D cardiac model where the interactions between descriptors are fully controlled. Then, we transfered them to a population of right ventricular meshes from 310 subjects (100 healthy and 210 patients with right ventricular disease) obtained from 3D echocardiography, where the link between shape and deformation is key for disease understanding. Our experiments underline the relevance of jointly considering shape and deformation descriptors, and that manifold alignment is preferable over fusion for our application. They also confirm at a finer scale the characteristic traits of the right ventricular diseases in our population.
MeSH term(s)	Algorithms ; Heart/diagnostic imaging ; Humans
Language	English
Publishing date	2021-10-23
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1356436-5
ISSN	1361-8423 ; 1361-8431 ; 1361-8415
ISSN (online)	1361-8423 ; 1361-8431
ISSN	1361-8415
DOI	10.1016/j.media.2021.102278
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Article ; Online: Prevalence and Clinical Characteristics of Patients with Pause-Dependent Atrioventricular Block

Sok-Sithikun Bun / Florian Asarisi / Nathan Heme / Fabien Squara / Didier Scarlatti / Philippe Taghji / Jean-Claude Deharo / Pamela Moceri / Emile Ferrari

Journal of Clinical Medicine, Vol 11, Iss 449, p

2022 Volume 449

Abstract: Background: In patients with complete atrioventricular block (AVB), the prevalence and clinical characteristics of patients with pause-dependent AVB (PD-AVB) is not known. Our objective was to assess the prevalence of PD-AVB in a population of patients ... ...

Abstract	Background: In patients with complete atrioventricular block (AVB), the prevalence and clinical characteristics of patients with pause-dependent AVB (PD-AVB) is not known. Our objective was to assess the prevalence of PD-AVB in a population of patients with complete (or high-grade) AVB. Methods: Twelve-lead electrocardiogram (ECG) and/or telemonitoring from patients admitted (from September 2020 to November 2021) for complete (or high-degree) AVB were prospectively collected at the University Hospital of Nice. The ECG tracings were analyzed by an electrophysiologist to determine the underlying mechanism of PD-AVB. Results: 100 patients were admitted for complete (or high-grade) AVB (men 55%; 82 ± 12 years). Arterial hypertension was present in 68% of the patients. Baseline QRS width was 117 ± 32 ms, and mean left ventricular ejection fraction was 56 ± 7%. Fourteen patients (14%) with PD-AVB were identified, and presented similar clinical characteristics in comparison with patients without PD-AVB, except for syncope (which was present in 86% versus 51% in the non-PD-AVB patients, p = 0.01). PD-AVB sequence was induced by: Premature atrial contraction (8/14), premature ventricular contraction (5/14), His extrasystole (1/14), conduction block in a branch (1/14), and atrial tachycardia termination (1/14). All patients with PD-AVB received a dual-chamber pacemaker during hospitalization. Conclusion: The prevalence of PD-AVB was 14%, and may be underestimated. PD-AVB episodes were more likely associated with syncope in comparison with patients without PD-AVB.
Keywords	pause-dependent atrioventricular block ; high-grade atrioventricular block ; prevalence ; syncope ; pacemaker ; Medicine ; R
Subject code	610 ; 616
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Fibrillatory Wave Amplitude Evolution during Persistent Atrial Fibrillation Ablation

Fabien Squara / Didier Scarlatti / Sok-Sithikun Bun / Pamela Moceri / Emile Ferrari / Olivier Meste / Vicente Zarzoso

Journal of Clinical Medicine, Vol 11, Iss 4519, p

Implications for Atrial Substrate and Fibrillation Complexity Assessment

2022 Volume 4519

Abstract: Background . Fibrillatory Wave Amplitude (FWA) has been described as a non-invasive marker of atrial fibrillation (AF) complexity, and it predicts catheter ablation outcome. However, the actual determinants of FWA remain incompletely understood. ... ...

Abstract	Background . Fibrillatory Wave Amplitude (FWA) has been described as a non-invasive marker of atrial fibrillation (AF) complexity, and it predicts catheter ablation outcome. However, the actual determinants of FWA remain incompletely understood. Objective . To assess the respective implications of anatomical atrial substrate and AF spectral characteristics for FWA. Methods . Persistent AF patients undergoing radiofrequency catheter ablation were included. FWA was measured on 1-min ECG by TQ concatenation in Lead I, V1, V2, and V5 at baseline and immediately before AF termination. FWA evolution during ablation was compared to that of AF dominant frequency (DF) measured by Independent Component Analysis on 12-lead ECG. FWA was compared to the extent of endocardial low-voltage areas (LVA I < 10%; II 10–20%; III 20–30%; IV > 30%), to the surface of healthy left atrial tissue, and to P-wave amplitude in sinus rhythm. The predictive value of FWA for AF recurrence during follow-up was assessed. Results . We included 29 patients. FWA remained stable along ablation procedure with comparable values at baseline and before AF termination (Lead I p = 0.54; V1 p = 0.858; V2 p = 0.215; V5 p = 0.14), whereas DF significantly decreased (5.67 ± 0.68 vs. 4.95 ± 0.58 Hz, p < 0.001). FWA was higher in LVA-I than in LVA-II, -III, and -IV in Lead I and V5 ( p = 0.02 and p = 0.01). FWA in V5 was strongly correlated with the surface of healthy left atrial tissue (R = 0.786; p < 0.001). FWA showed moderate to strong correlation to P-wave amplitude in all leads. Finally, FWA did not predict AF recurrence after a follow-up of 23.3 ± 9.8 months. Conclusions . These findings suggest that FWA is unrelated to AF complexity but is mainly determined by the amount of viable atrial myocytes. Therefore, FWA should only be referred as a marker of atrial tissue pathology.
Keywords	atrial fibrillation ; ECG ; ablation ; Medicine ; R
Subject code	616
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Does Unidirectional Block Exist after a Radiofrequency Line Creation? Insights from Ultra-High-Density Mapping (The UNIBLOCK Study)

Sok-Sithikun Bun / Antoine Da Costa / Jean-Baptiste Guichard / Ziad Khoueiry / Fabien Squara / Didier Scarlatti / Philippe Taghji / Pamela Moceri / Emile Ferrari

Journal of Clinical Medicine, Vol 10, Iss 2512, p

2021 Volume 2512

Abstract: Background: Whether unidirectional conduction block (UB) can be observed after creation of a radiofrequency (RF) line is still debated. Previous studies reported a prevalence of 9 to 33% of UB, but the assessment was performed using a point-by-point ... ...

Abstract	Background: Whether unidirectional conduction block (UB) can be observed after creation of a radiofrequency (RF) line is still debated. Previous studies reported a prevalence of 9 to 33% of UB, but the assessment was performed using a point-by-point recording across the line. Ultra-high-density (UHD) system may bring some new insights on the exact prevalence of UB. Purpose: A prospective study was conducted to assess the prevalence of UB and bidirectional block (BB) using UHD system after RF line creation. Methods: Patients referred for atrial RF ablation procedure were included in this multicenter prospective study. UHD maps were performed by pacing both sides of the created line. Results: A total of 80 maps were created in 40 patients (67 ± 12 years, 70% male) by pacing (mean cycle length 600 ± 57 ms) from both sides of the cavotricuspid isthmus line. After a 47 ± 17 min waiting time after the last RF application, UHD maps (mean number of 4842 ± 5010 electrograms, acquired during 6 ± 5 min) showed that BB was unambiguously confirmed on all of them. UB was not observed in any map. After a mean follow-up of 12 ± 4 months, 6 (14%) patients experienced an arrhythmia recurrence. Conclusion: After creation of an RF line, no case of UB was observed using UHD mapping, suggesting that the presence of a conduction block along a RF line is always associated with a block in the opposite direction.
Keywords	unidirectional block ; radiofrequency line ; ultra-high-density mapping ; Medicine ; R
Subject code	616
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Is pulmonary embolism recurrence linked with the severity of the first event? A French retrospective cohort study

Pamela Moceri / Emile Ferrari / Etienne Fourrier / Florian Asarisi / Nathan Heme / Nassim Redjimi / Nathalie Berkane / Mohamed Labbaoui / Jean Philippe Breittmayer / Sok Sithikun Bun / Fabien Squara

BMJ Open, Vol 11, Iss

2021 Volume 9

Keywords	Medicine ; R
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Accuracy of prenatal screening for congenital heart disease in population

Cornélie Suard / Audrey Flori / Florent Paoli / Anderson Loundou / Virginie Fouilloux / Sabine Sigaudy / Fabrice Michel / Julie Antomarchi / Pamela Moceri / Véronique Paquis-Flucklinger / Claude D'Ercole / Florence Bretelle

PLoS ONE, Vol 15, Iss 10, p e

A retrospective study in Southern France.

2020 Volume 0239476

Abstract: Congenital heart diseases (CHDs) are the most common congenital malformations. The objective of our study was to evaluate the prenatal screening accuracy of congenital heart disease (CHD) in Southern France and to evaluate the impact of a prenatal ... ...

Abstract	Congenital heart diseases (CHDs) are the most common congenital malformations. The objective of our study was to evaluate the prenatal screening accuracy of congenital heart disease (CHD) in Southern France and to evaluate the impact of a prenatal diagnosis on pregnancies outcomes and neonatal outcomes. We performed a bicentric, retrospective observational study in the southern region over 4 years was conducted between 1 January 2014 and 31 December 2017. All foetuses and children under one year of age with CHD monitored in the UTHs (University Teaching Hospitals) in Marseille and Nice were included. CHD cases were divided into 3 groups: group 1, those with no possible options for anatomical repair; group 2, those with anatomical repair possibilities but that may require neonatal cardiologic management; and group 3, those with anatomical repair possibilities that do not require an emergency neonatal procedure. Among the 249070 deliveries during the study period, 677 CHD cases were included in the study. The overall prenatal screening rate was 71.5%. The screening rates were 97.8%, 63.6%, and 65.9% for groups 1, 2 and 3, respectively. Among group 2 CHD cases, 80% of the transpositions of the great arteries, 56% of the aortic coarctations, and 20% of the total anomalous pulmonary venous returns were detected during the prenatal period. A genetic anomaly was found in 16% of CHD cases. The overall mortality rate was 11.3% with a higher death rate in cases of prenatal screening (17.2% versus 2.1%; p < 0.001). However, when focusing only on children who died of CHD, prenatal screening did not create an impact (56.6% versus 100%, p = 0,140). Our data showed that the prenatal screening rate of CHD appears satisfactory in Southern France. Nevertheless, it could be improved for some CHD. This study did not find any benefit in terms of mortality from prenatal screening for CHD.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Andersen’s syndrome mutants produce a knockdown of inwardly rectifying K+ channel in mouse skeletal muscle in vivo

Simkin, Dina / Gaëlle Robin / Serena Giuliano / Ana Vukolic / Pamela Moceri / Nicolas Guy / Kay-Dietrich Wagner / Alain Lacampagne / Bruno Allard / Saïd Bendahhou

Cell and tissue research. 2018 Feb., v. 371, no. 2

2018

Abstract: Andersen’s syndrome (AS) is a rare autosomal disorder that has been defined by the triad of periodic paralysis, cardiac arrhythmia, and developmental anomalies. AS has been directly linked to over 40 different autosomal dominant negative loss-of-function ...

Abstract	Andersen’s syndrome (AS) is a rare autosomal disorder that has been defined by the triad of periodic paralysis, cardiac arrhythmia, and developmental anomalies. AS has been directly linked to over 40 different autosomal dominant negative loss-of-function mutations in the KCNJ2 gene, encoding for the tetrameric strong inward rectifying K⁺ channel KIR2.1. While KIR2.1 channels have been suggested to contribute to setting the resting membrane potential (RMP) and to control the duration of the action potential (AP) in skeletal and cardiac muscle, the mechanism by which AS mutations produce such complex pathophysiological symptoms is poorly understood. Thus, we use an adenoviral transduction strategy to study in vivo subcellular distribution of wild-type (WT) and AS-associated mutant KIR2.1 channels in mouse skeletal muscle. We determined that WT and D71V AS mutant KIR2.1 channels are localized to the sarcolemma and the transverse tubules (T-tubules) of skeletal muscle fibers, while the ∆314-315 AS KIR2.1 mutation prevents proper trafficking of the homo- or hetero-meric channel complexes. Whole-cell voltage-clamp recordings in individual skeletal muscle fibers confirmed the reduction of inwardly rectifying K⁺ current (IK₁) after transduction with ∆314-315 KIR2.1 as compared to WT channels. Analysis of skeletal muscle function revealed reduced force generation during isometric contraction as well as reduced resistance to muscle fatigue in extensor digitorum longus muscles transduced with AS mutant KIR2.1. Together, these results suggest that KIR2.1 channels may be involved in the excitation–contraction coupling process required for proper skeletal muscle function. Our findings provide clues to mechanisms associated with periodic paralysis in AS.
Keywords	action potentials ; arrhythmia ; genes ; mice ; muscle fatigue ; muscles ; mutants ; mutation ; myocardium ; myotubes ; paralysis ; potassium ; potassium channels ; skeletal muscle
Language	English
Dates of publication	2018-02
Size	p. 309-323.
Publishing place	Springer Berlin Heidelberg
Document type	Article
ZDB-ID	125067-x
ISSN	1432-0878 ; 0302-766X
ISSN (online)	1432-0878
ISSN	0302-766X
DOI	10.1007/s00441-017-2696-7
Database	NAL-Catalogue (AGRICOLA)

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